This proposal seeks support to develop and study an educational video game for children with diabetes. Diabetes is managed largely by patients themselves; patient knowledge and attitude are critical to the success of treatment. Phase I established the feasibility of using a computer game to teach children about diabetes. Concurrently, a prototype game was designed for a popular home-based video game system. Phase II will expand this prototype into a commercial quality educational video game and study its efficacy in diabetes education in a controlled trial. Children with diabetes, age 10 to 14, will receive the video game to use at home for two months. Researchers will measure subject's knowledge of diabetes, attitudes, self-efficacy, behavior and metabolic control using pre-tests, post-tests and a six-month follow-up. The results will be compared with patients not receiving the intervention. As a check on the measures, the game cartridges will unobtrusively measure usage and the players' ability to master the diabetes-based game strategy. The researchers hypothesize that a properly designed educational intervention, when combined with intrinsic motivations of entertainment quality video games, could lead to significant improvements in the knowledge, attitudes, self-efficacy, behavior and metabolic control of children with diabetes.